Renal cell carcinoma CT: Difference between revisions
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<br> The following guidelines of the American Urological Association in 2013 state the following regarding the use of CT in renal cell carcinoma: | <br> The following guidelines of the American Urological Association in 2013 state the following regarding the use of CT in renal cell carcinoma: | ||
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{|border="1" style="border-collapse:collapse; text-align:left;" cellpadding="5" align="center"|+ '''''Use of CT in Renal Cell Carcinoma<ref name="pmid23665399">{{cite journal| author=Donat SM, Diaz M, Bishoff JT, Coleman JA, Dahm P, Derweesh IH et al.| title=Follow-up for Clinically Localized Renal Neoplasms: AUA Guideline. | journal=J Urol | year= 2013 | volume= 190 | issue= 2 | pages= 407-16 | pmid=23665399 | doi=10.1016/j.juro.2013.04.121 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23665399 }} </ref>''''' | {|border="1" style="border-collapse:collapse; text-align:left;" cellpadding="5" align="center" | ||
|+ '''''Use of CT in Renal Cell Carcinoma<ref name="pmid23665399">{{cite journal| author=Donat SM, Diaz M, Bishoff JT, Coleman JA, Dahm P, Derweesh IH et al.| title=Follow-up for Clinically Localized Renal Neoplasms: AUA Guideline. | journal=J Urol | year= 2013 | volume= 190 | issue= 2 | pages= 407-16 | pmid=23665399 | doi=10.1016/j.juro.2013.04.121 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23665399 }} </ref>''''' | |||
| bgcolor="#d9ff54"|'''Patient Profile''' || bgcolor="#d9ff54"|'''Use of CT'''|| bgcolor="#d9ff54"|'''Evidence Strength''' | | bgcolor="#d9ff54"|'''Patient Profile''' || bgcolor="#d9ff54"|'''Use of CT'''|| bgcolor="#d9ff54"|'''Evidence Strength''' | ||
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Revision as of 19:05, 11 January 2014
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
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Renal cell carcinoma Microchapters |
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Diagnosis |
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Treatment |
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Case Studies |
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Renal cell carcinoma CT On the Web |
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American Roentgen Ray Society Images of Renal cell carcinoma CT |
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Risk calculators and risk factors for Renal cell carcinoma CT |
Overview
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Renal cell carcinoma Microchapters |
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Diagnosis |
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Treatment |
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Case Studies |
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Renal cell carcinoma CT On the Web |
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American Roentgen Ray Society Images of Renal cell carcinoma CT |
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Risk calculators and risk factors for Renal cell carcinoma CT |
Computed Tomography
Both CT and MRI may be used to detect neoplastic masses that may define renal cell carcinoma or metastasis of the primary cancer. CT scan and use of intravenous (IV) contrast is generally used for work-up and follow-up of patients with renal cell carcinoma. Enhancing renal masses on CT scan is strongly indicative of the presence of a renal tumor.[1]
It is always important to note the significance of radiation exposure in the recurrent use of CT scan for surveillance.
The following guidelines of the American Urological Association in 2013 state the following regarding the use of CT in renal cell carcinoma:
| Patient Profile | Use of CT | Evidence Strength |
| Low Risk Patient (pT1, N0, Nx) | Baseline abdominal CT (or MRI) for nephron sparing surgery and CT (or US or MRI) for radical nephrectomy within 3-12 months following renal surgery Additional CT (or US or MRI) may be performed in patients following radical nephrectomy if initial post-op baseline image is negative |
Expert opinion C |
| Moderate to High Risk Patients (pT2-4N0 Nx or any stage N+) | Baseline chest and abdominal CT (or MRI) within 3-6 months following surgery with continued imaging (US, CXR, CT, or MRI) every 6 months for at least 3 years and annually thereafter to 5 years. Site specific imaging is warranted by clinical symptoms suggestive of recurrence or metastatic spread. Imaging (US, CXR, CT, or MRI) beyond 5 years may be performed at the discretion of the clinician | C |
| Active surveillance | Cross-sectional abdominal scanning (CT or MRI) within 6 months of active surveillance initiation to establish a growth rate. Further imaging is recommended at least annually thereafter | C |
| Ablation | Patients undergo cross-sectional CT or MRI with and without IV contrast unless contraindicated at 3 and 6 months following ablative therapy to assess treatment success. Annual abdominal CT or MRI should follow for 5 years. Individual CT (or MRI) beyond 5 years is based on individual patient risk factors | C |
Patient 1
Patient 2
Patient 3
Patient 4
References
- ↑ Cohen HT, McGovern FJ (2005). "Renal-cell carcinoma". N Engl J Med. 353 (23): 2477–90. doi:10.1056/NEJMra043172. PMID 16339096 Check
|pmid=value (help). - ↑ Donat SM, Diaz M, Bishoff JT, Coleman JA, Dahm P, Derweesh IH; et al. (2013). "Follow-up for Clinically Localized Renal Neoplasms: AUA Guideline". J Urol. 190 (2): 407–16. doi:10.1016/j.juro.2013.04.121. PMID 23665399.